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Ngandu DN, Sclar GD, Ahmed A, Awale SA, Fernandes C, Goldstein J, Hashmi H, Joshi S, Mallipeddi S, Mudasigana ML, Nicoll L, Parker DE, Price G, Tucker A, Vinton EA, Volkers A, Jacobs EA, Fairfield KM. Reaching Structurally Vulnerable Populations Using Low-Barrier COVID-19 Testing Clinics Co-Created with Community-Based Organizations. J Gen Intern Med 2024:10.1007/s11606-024-08889-2. [PMID: 39020226 DOI: 10.1007/s11606-024-08889-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 06/12/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND The COVID-19 pandemic disproportionately affected people from structurally vulnerable communities. There was a need to improve COVID-19 testing in these communities to reduce viral spread and connect to treatment. OBJECTIVE We created a partnership between an academic medical center and three community-based organizations (CBOs) to offer low-barrier COVID-19 walk-up testing clinics in Portland, Maine. Our objective was to examine whether the co-created testing clinics reached structurally vulnerable populations. DESIGN The clinics offered COVID-19 rapid antigen tests three times a week outside CBO sites from January 2022 to May 2023. Clinic staff administered a brief survey on reason for testing and then instructed participants on how to self-swab. While staff processed the test, participants were invited to complete an additional survey about their demographics and testing perceptions. PARTICIPANTS Adults seeking COVID-19 testing with specific outreach to people who are unhoused, immigrants, and low-income and/or uninsured. MAIN MEASURES Number of tests conducted and result, reasons for testing, and testing perceptions. KEY RESULTS Of 246 completed tests, 18 were positive for COVID-19 (7%). Participants sought testing for a variety of reasons, including symptoms (60%), close contact exposure (29%), and/or need for a negative test result to access services or an activity (33%). Overall, people primarily tested due to symptoms with only 7% testing due to close contact exposure alone. The clinics reached vulnerable populations. Among the 130 people completing the participant survey, 39% were unhoused, 22% spoke a language other than English at home, 23% were uninsured, and 46% earned less than $20,000 in 2019. Qualitative field notes captured key elements of clinics that influenced reach, and how this collaboration with CBOs helped build trust with our target populations. CONCLUSIONS Providing low-barrier walk-up clinics partnering with trusted CBOs was observed to be helpful in reaching structurally vulnerable populations for COVID-19 testing.
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Affiliation(s)
- David N Ngandu
- MaineHealth Institute for Research, Scarborough, ME, USA
| | - Gloria D Sclar
- MaineHealth Institute for Research, Scarborough, ME, USA
| | - Ambia Ahmed
- MaineHealth Institute for Research, Scarborough, ME, USA
| | - Sumayo A Awale
- MaineHealth Institute for Research, Scarborough, ME, USA
| | | | - Joshua Goldstein
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA, USA
| | - Hina Hashmi
- MaineHealth Institute for Research, Scarborough, ME, USA
| | | | | | | | - Leslie Nicoll
- Friends of the Portland Community Free Clinic, Portland, ME, USA
| | | | - Grace Price
- MaineHealth Institute for Research, Scarborough, ME, USA
- Department of Medicine, Maine Medical Center, Portland, ME, USA
| | - Ann Tucker
- Greater Portland Health, Portland, ME, USA
| | - Elizabeth A Vinton
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA, USA
| | | | | | - Kathleen M Fairfield
- MaineHealth Institute for Research, Scarborough, ME, USA.
- Department of Medicine, Maine Medical Center, Portland, ME, USA.
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Guilamo-Ramos V, Thimm-Kaiser M, Benzekri A, Johnson C, Williams D, Wilhelm-Hilkey N, Goodman M, Hagan H. Application of a Heuristic Framework for Multilevel Interventions to Eliminate the Impact of Unjust Social Processes and Other Harmful Social Determinants of Health. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:446-458. [PMID: 38607535 PMCID: PMC11239765 DOI: 10.1007/s11121-024-01658-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 04/13/2024]
Abstract
There is consensus about the importance of developing a strong cadre of effective multilevel interventions to eliminate the impacts of unjust social processes, such as structural racism and other harmful social determinants of health (SDOH), on health inequities in the USA. However, the available cadre of rigorously evaluated evidence-based interventions for SDOH mitigation remains underdeveloped relative to the magnitude of historic and current health inequities. The proposed manuscript addresses this gap in two ways: first, by introducing a heuristic framework to inform decisions in multilevel intervention development, study design, and selection of analytic methods and, second, by providing a roadmap for future applications of the framework in multilevel intervention research through an exemplar application using the ongoing NIH-funded evaluation study of the Nurse-Community-Family Partnership (NCFP) intervention. NCFP leverages individual, family, institutional, and system factors to shape COVID-19 mitigation outcomes at the individual and household levels. NCFP takes an approach informed by the heuristic framework to addressing and mitigating unjust social processes and other harmful SDOH. We discuss the application of a two-arm parallel explanatory group randomized trial to evaluate the efficacy of NCFP in improving the primary (COVID-19 testing uptake) and secondary (adoption of COVID-19 control measures, COVID-19 vaccine uptake, mutual aid capacity, etc.) outcomes at the individual and household levels. The analysis approach relies on random-intercept models, and we calculate the variance partitioning coefficient to estimate the extent to which household- and individual-level variables contribute to the outcome, allowing examination of NCFP effects at multiple levels.
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Affiliation(s)
- Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health, Johns Hopkins University, Washington, DC, 20001, USA.
- Institute for Policy Solutions, Johns Hopkins University School of Nursing, Johns Hopkins University, Washington, DC, 20001, USA.
- School of Nursing, Johns Hopkins University, Baltimore, MD, 21205, USA.
- Presidential Advisory Council On HIV/AIDS, US Department of Health and Human Services, Washington, DC, USA.
| | - Marco Thimm-Kaiser
- Center for Latino Adolescent and Family Health, Johns Hopkins University, Washington, DC, 20001, USA
- Institute for Policy Solutions, Johns Hopkins University School of Nursing, Johns Hopkins University, Washington, DC, 20001, USA
- School of Nursing, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Adam Benzekri
- Center for Latino Adolescent and Family Health, Johns Hopkins University, Washington, DC, 20001, USA
- Institute for Policy Solutions, Johns Hopkins University School of Nursing, Johns Hopkins University, Washington, DC, 20001, USA
- School of Nursing, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Celia Johnson
- Center for Latino Adolescent and Family Health, Johns Hopkins University, Washington, DC, 20001, USA
- Institute for Policy Solutions, Johns Hopkins University School of Nursing, Johns Hopkins University, Washington, DC, 20001, USA
- School of Nursing, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Desiree Williams
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, 10003, USA
- Department of Social Behavioral Sciences, School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Nash Wilhelm-Hilkey
- Center for Latino Adolescent and Family Health, Johns Hopkins University, Washington, DC, 20001, USA
| | - Melody Goodman
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Holly Hagan
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, 10003, USA
- Department of Social Behavioral Sciences, School of Global Public Health, New York University, New York, NY, 10003, USA
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Compton WM, Hooper MW, Hodes RJ, Pérez-Stable EJ. Lessons From COVID-19 Testing Research: The Power of Rapid Response. Am J Public Health 2024; 114:S343-S346. [PMID: 38776500 PMCID: PMC11111383 DOI: 10.2105/ajph.2024.307653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Wilson M Compton
- All authors are with the National Institutes of Health in Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse. Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities. Richard J. Hodes is with the National Institute on Aging
| | - Monica Webb Hooper
- All authors are with the National Institutes of Health in Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse. Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities. Richard J. Hodes is with the National Institute on Aging
| | - Richard J Hodes
- All authors are with the National Institutes of Health in Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse. Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities. Richard J. Hodes is with the National Institute on Aging
| | - Eliseo J Pérez-Stable
- All authors are with the National Institutes of Health in Bethesda, MD. Wilson M. Compton is with the National Institute on Drug Abuse. Monica Webb Hooper and Eliseo J. Pérez-Stable are with the National Institute on Minority Health and Health Disparities. Richard J. Hodes is with the National Institute on Aging
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Windsor L, Benoit E, Kwan P, Tan K, Richmond A. Protection of Participants in Community-Engaged Research by Institutional Review Boards: A Call for Action. Am J Public Health 2024; 114:S360-S365. [PMID: 38547467 PMCID: PMC11111368 DOI: 10.2105/ajph.2024.307592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2024] [Indexed: 05/24/2024]
Affiliation(s)
- Liliane Windsor
- Liliane Windsor and Kevin Tan are with the School of Social Work, University of Illinois Urbana-Champaign, Urbana, IL. Ellen Benoit is with the North Jersey Community Research Initiative, Newark, NJ. Patchareeya Kwan is with the Department of Health Sciences, California State University, Northridge. Al Richmond is with Community-Campus Partnerships for Health, Raleigh, NC
| | - Ellen Benoit
- Liliane Windsor and Kevin Tan are with the School of Social Work, University of Illinois Urbana-Champaign, Urbana, IL. Ellen Benoit is with the North Jersey Community Research Initiative, Newark, NJ. Patchareeya Kwan is with the Department of Health Sciences, California State University, Northridge. Al Richmond is with Community-Campus Partnerships for Health, Raleigh, NC
| | - Patchareeya Kwan
- Liliane Windsor and Kevin Tan are with the School of Social Work, University of Illinois Urbana-Champaign, Urbana, IL. Ellen Benoit is with the North Jersey Community Research Initiative, Newark, NJ. Patchareeya Kwan is with the Department of Health Sciences, California State University, Northridge. Al Richmond is with Community-Campus Partnerships for Health, Raleigh, NC
| | - Kevin Tan
- Liliane Windsor and Kevin Tan are with the School of Social Work, University of Illinois Urbana-Champaign, Urbana, IL. Ellen Benoit is with the North Jersey Community Research Initiative, Newark, NJ. Patchareeya Kwan is with the Department of Health Sciences, California State University, Northridge. Al Richmond is with Community-Campus Partnerships for Health, Raleigh, NC
| | - Al Richmond
- Liliane Windsor and Kevin Tan are with the School of Social Work, University of Illinois Urbana-Champaign, Urbana, IL. Ellen Benoit is with the North Jersey Community Research Initiative, Newark, NJ. Patchareeya Kwan is with the Department of Health Sciences, California State University, Northridge. Al Richmond is with Community-Campus Partnerships for Health, Raleigh, NC
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Maras SA, Osinuga A, Gallo IV, Rodriguez A, Corriveau E, Milligan K, Kelley A, Carr T, Dave G. Qualitative Evaluation of RADx-UP Projects Addressing COVID-19 Testing Disparities Among Underserved Populations. Am J Public Health 2024; 114:S410-S415. [PMID: 38547469 PMCID: PMC11111372 DOI: 10.2105/ajph.2024.307632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 05/24/2024]
Abstract
In this article, we present findings from a May 2022 to March 2023 qualitative evaluation of Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) projects addressing COVID-19 testing disparities among underserved populations. Interviews with academic and community partners from 13 RADx-UP projects revealed that despite the pandemic, projects were able to build trust and relationships with underserved populations. By prioritizing community voices during a public health emergency, RADx-UP projects improved health equity and pandemic preparedness in these communities, successfully conducted community-engaged research, and built long-lasting community partnerships. (Am J Public Health. 2024;114(S5):S410-S415. https://doi.org/10.2105/AJPH.2024.307632).
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Affiliation(s)
- Shelly A Maras
- Shelly A. Maras, Abisola Osinuga, Tara Carr, and Gaurav Dave are with the School of Medicine, University of North Carolina at Chapel Hill. Iñigo Verduzco Gallo is with the Genome Center and Center for Advancing Cancer Health Equity, University of California, Davis. Arturo Rodriguez is with the Department of Health, Wellness and Animal Services, Brownsville, TX. Erin Corriveau is with the Department of Family Medicine and Community Health, University of Kansas City, Kansas City, KS. Kelley Milligan is with Allyson Kelley and Associates PLLC, Sacramento, CA. Allyson Kelley is with Allyson Kelley and Associates PLLC, Sisters, OR
| | - Abisola Osinuga
- Shelly A. Maras, Abisola Osinuga, Tara Carr, and Gaurav Dave are with the School of Medicine, University of North Carolina at Chapel Hill. Iñigo Verduzco Gallo is with the Genome Center and Center for Advancing Cancer Health Equity, University of California, Davis. Arturo Rodriguez is with the Department of Health, Wellness and Animal Services, Brownsville, TX. Erin Corriveau is with the Department of Family Medicine and Community Health, University of Kansas City, Kansas City, KS. Kelley Milligan is with Allyson Kelley and Associates PLLC, Sacramento, CA. Allyson Kelley is with Allyson Kelley and Associates PLLC, Sisters, OR
| | - Iñigo Verduzco Gallo
- Shelly A. Maras, Abisola Osinuga, Tara Carr, and Gaurav Dave are with the School of Medicine, University of North Carolina at Chapel Hill. Iñigo Verduzco Gallo is with the Genome Center and Center for Advancing Cancer Health Equity, University of California, Davis. Arturo Rodriguez is with the Department of Health, Wellness and Animal Services, Brownsville, TX. Erin Corriveau is with the Department of Family Medicine and Community Health, University of Kansas City, Kansas City, KS. Kelley Milligan is with Allyson Kelley and Associates PLLC, Sacramento, CA. Allyson Kelley is with Allyson Kelley and Associates PLLC, Sisters, OR
| | - Arturo Rodriguez
- Shelly A. Maras, Abisola Osinuga, Tara Carr, and Gaurav Dave are with the School of Medicine, University of North Carolina at Chapel Hill. Iñigo Verduzco Gallo is with the Genome Center and Center for Advancing Cancer Health Equity, University of California, Davis. Arturo Rodriguez is with the Department of Health, Wellness and Animal Services, Brownsville, TX. Erin Corriveau is with the Department of Family Medicine and Community Health, University of Kansas City, Kansas City, KS. Kelley Milligan is with Allyson Kelley and Associates PLLC, Sacramento, CA. Allyson Kelley is with Allyson Kelley and Associates PLLC, Sisters, OR
| | - Erin Corriveau
- Shelly A. Maras, Abisola Osinuga, Tara Carr, and Gaurav Dave are with the School of Medicine, University of North Carolina at Chapel Hill. Iñigo Verduzco Gallo is with the Genome Center and Center for Advancing Cancer Health Equity, University of California, Davis. Arturo Rodriguez is with the Department of Health, Wellness and Animal Services, Brownsville, TX. Erin Corriveau is with the Department of Family Medicine and Community Health, University of Kansas City, Kansas City, KS. Kelley Milligan is with Allyson Kelley and Associates PLLC, Sacramento, CA. Allyson Kelley is with Allyson Kelley and Associates PLLC, Sisters, OR
| | - Kelley Milligan
- Shelly A. Maras, Abisola Osinuga, Tara Carr, and Gaurav Dave are with the School of Medicine, University of North Carolina at Chapel Hill. Iñigo Verduzco Gallo is with the Genome Center and Center for Advancing Cancer Health Equity, University of California, Davis. Arturo Rodriguez is with the Department of Health, Wellness and Animal Services, Brownsville, TX. Erin Corriveau is with the Department of Family Medicine and Community Health, University of Kansas City, Kansas City, KS. Kelley Milligan is with Allyson Kelley and Associates PLLC, Sacramento, CA. Allyson Kelley is with Allyson Kelley and Associates PLLC, Sisters, OR
| | - Allyson Kelley
- Shelly A. Maras, Abisola Osinuga, Tara Carr, and Gaurav Dave are with the School of Medicine, University of North Carolina at Chapel Hill. Iñigo Verduzco Gallo is with the Genome Center and Center for Advancing Cancer Health Equity, University of California, Davis. Arturo Rodriguez is with the Department of Health, Wellness and Animal Services, Brownsville, TX. Erin Corriveau is with the Department of Family Medicine and Community Health, University of Kansas City, Kansas City, KS. Kelley Milligan is with Allyson Kelley and Associates PLLC, Sacramento, CA. Allyson Kelley is with Allyson Kelley and Associates PLLC, Sisters, OR
| | - Tara Carr
- Shelly A. Maras, Abisola Osinuga, Tara Carr, and Gaurav Dave are with the School of Medicine, University of North Carolina at Chapel Hill. Iñigo Verduzco Gallo is with the Genome Center and Center for Advancing Cancer Health Equity, University of California, Davis. Arturo Rodriguez is with the Department of Health, Wellness and Animal Services, Brownsville, TX. Erin Corriveau is with the Department of Family Medicine and Community Health, University of Kansas City, Kansas City, KS. Kelley Milligan is with Allyson Kelley and Associates PLLC, Sacramento, CA. Allyson Kelley is with Allyson Kelley and Associates PLLC, Sisters, OR
| | - Gaurav Dave
- Shelly A. Maras, Abisola Osinuga, Tara Carr, and Gaurav Dave are with the School of Medicine, University of North Carolina at Chapel Hill. Iñigo Verduzco Gallo is with the Genome Center and Center for Advancing Cancer Health Equity, University of California, Davis. Arturo Rodriguez is with the Department of Health, Wellness and Animal Services, Brownsville, TX. Erin Corriveau is with the Department of Family Medicine and Community Health, University of Kansas City, Kansas City, KS. Kelley Milligan is with Allyson Kelley and Associates PLLC, Sacramento, CA. Allyson Kelley is with Allyson Kelley and Associates PLLC, Sisters, OR
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Gibbons GH, Pérez-Stable EJ. Harnessing the Power of Community-Engaged Research. Am J Public Health 2024; 114:S7-S11. [PMID: 38207272 PMCID: PMC10785163 DOI: 10.2105/ajph.2023.307528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 01/13/2024]
Affiliation(s)
- Gary H Gibbons
- Eliseo J. Pérez-Stable is the director of the National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Gary H. Gibbons is the director of the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Eliseo J Pérez-Stable
- Eliseo J. Pérez-Stable is the director of the National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Gary H. Gibbons is the director of the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
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Cross LM, DeFosset A, Yusuf B, Conserve D, Anderson R, Carilli C, Kibbe W, Cohen-Wolkowiez M, Richmond A, Corbie G, Dave G. Exploring barriers and facilitators of implementing an at-home SARS-CoV-2 antigen self-testing intervention: The Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) initiatives. PLoS One 2023; 18:e0294458. [PMID: 37971996 PMCID: PMC10653400 DOI: 10.1371/journal.pone.0294458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Evaluating community-based programs provides value to researchers, funding entities, and community stakeholders involved in program implementation, and can increase program impact and sustainability. To understand factors related to program implementation, we aimed to capture the perspective of community partners engaged in organizing and executing community-engaged programs to distribute COVID-19 at-home tests in underserved communities. METHODS We conducted semi-structured interviews and focus groups with community-based stakeholders informed by the Outcomes for Implementation Research framework. RESULTS Findings describe how community-engaged communication and dissemination strategies drove program adoption among grassroots stakeholders. Establishing and sustaining trusted relationships was vital to engaging partners with aligned values and capacity. Respondents characterized the programs as generally feasible and appropriate, and community partners felt capable of delivering the program successfully. However, they also described an increased burden on their workforce and desired more significant support. Respondents recognized the programs' community engagement practices as a critical facilitator of acceptability and impact. DISCUSSION Implementation evaluation aims to inform current and future community outreach and engagement efforts with best practices. As we continue to inform and advance community-engaged disaster response practice, a parallel reimagining of public health funding mechanisms and timelines could provide a foundation for trust, collaboration, and community resiliency that endures beyond a given crisis.
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Affiliation(s)
- Lisa Maria Cross
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Amelia DeFosset
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Bola Yusuf
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Donaldson Conserve
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, D.C, United States of America
| | - Rakiah Anderson
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Christina Carilli
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Warren Kibbe
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, United States of America
| | - Michael Cohen-Wolkowiez
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, United States of America
| | - Alan Richmond
- Community-Campus Partnerships for Health, Raleigh, North Carolina, United States of America
| | - Giselle Corbie
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Gaurav Dave
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Compton WM, Einstein EB, Wargo EM, Crump AD, Aklin WM. Racial inequities and addiction research. Drug Alcohol Depend 2023; 251:110940. [PMID: 37639897 PMCID: PMC10538379 DOI: 10.1016/j.drugalcdep.2023.110940] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/11/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
What accounts for variation across racial and ethnic groups in drug use and harms related to substance use? While explanatory mechanisms for racial and ethnic disparities include differential access to and use of health services, a myriad of other factors, including racism and historical trauma, contribute to drug-related disparities. Furthermore, the addiction scientific workforce, like the full biomedical research enterprise, lacks diversity. This deficit undercuts U.S. scientific leadership and is a major challenge for the field. To address these entrenched problems, the National Institute on Drug Abuse (NIDA) is prioritizing research on health disparities and supporting multiple efforts to enhance scientific workforce diversity. Studies on substance use trends and emerging threats must measure disparities and track progress in reducing disparities, but also acknowledge the limitations of race and ethnicity-based data. Researchers must take the bold step of proposing studies that elucidate causal mechanisms which have the potential to be ameliorated by novel policies and practices. Critically, the impact of racism on all aspects of the substance use trajectory must be assessed to better tailor prevention, harm reduction, treatment, and recovery-support interventions to the specific circumstances of those who need them. Particular attention should be given to people who are incarcerated, who are experiencing homelessness, and who have a history of adverse childhood experiences. Training the next generation of the addiction science workforce needs to address structural barriers to participation with partnerships between funders, such as NIDA, and grantee organizations.
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Affiliation(s)
- Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA.
| | - Emily B Einstein
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Eric M Wargo
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Aria D Crump
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Will M Aklin
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
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Hedges JR, Chow DC, Fogelgren B, Braun KL, Tsark JU, Ordinado S, Berry MJ, Yanagihara R, Mokuau N. Health Disparities Investigator Development through a Team-Science Pilot Projects Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5336. [PMID: 37047951 PMCID: PMC10094603 DOI: 10.3390/ijerph20075336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/12/2023] [Accepted: 03/29/2023] [Indexed: 06/19/2023]
Abstract
Profound health disparities are widespread among Native Hawaiians, other Pacific Islanders, and Filipinos in Hawai'i. Efforts to reduce and eliminate health disparities are limited by a shortage of investigators trained in addressing the genetic, socio economic, and environmental factors that contribute to disparities. In this conference proceedings report from the 2022 RCMI Consortium National Conference, we describe our mentoring program, with an emphasis on community-engaged research. Elements include our encouragement of a team-science, customized Pilot Projects Program (PPP), a Mentoring Bootcamp, and a mentoring support network. During 2017-2022, we received 102 PPP preproposals. Of these, 45 (48%) were invited to submit full proposals, and 22 (19%) were awarded (8 basic biomedical, 7 clinical, 7 behavioral). Eighty-three percent of awards were made to early-career faculty (31% ethnic minority, 72% women). These 22 awards generated 77 related publications; 84 new grants were submitted, of which 31 were awarded with a resultant return on investment of 5.9. From 5 to 11 investigators were supported by PPP awards each year. A robust usage of core services was observed. Our descriptive report (as part of a scientific conference session on RCMI specialized centers) focuses on a mentoring vehicle and shows how it can support early-stage investigators in pursuing careers in health disparities research.
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Affiliation(s)
- Jerris R. Hedges
- Departments of Medicine and Surgery, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA
| | - Dominic C. Chow
- Department of Medicine, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA
| | - Benjamin Fogelgren
- Department of Anatomy, Biochemistry and Physiology, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA
| | - Kathryn L. Braun
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - JoAnn U. Tsark
- Research Corporation University of Hawai‘i, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Susan Ordinado
- Pacific Biosciences Research Center, School of Ocean & Earth Science & Technology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Marla J. Berry
- Pacific Biosciences Research Center, School of Ocean & Earth Science & Technology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Richard Yanagihara
- Departments of Pediatrics and Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA
| | - Noreen Mokuau
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
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